Health and Medical News and Resources

General interest items edited by Janice Flahiff

What Does the Dartmouth Atlas Have to Say About the Politics of the ACA?

From the 27 December 2012 article at The Health Care Blog by Anubhav Kaul, MD, Peter Bhandari, and Thom Walsh, PhD

…The Dartmouth Atlas Project is an online database which collects Medicare spending and utilization data from around the country. Information gathered from the database has shown immense variation in the way medical resources are utilized by even similar regions, communities, and health care organization. Evidence has repeatedly shown that, from a population perspective, areas that spend more on medical care do not consistently benefit from increased quality of care or patient wellbeing. Variation in the type of care delivered can be attributed to diverse incidence and prevalence of disease severity or the type of care a well- informed patient chooses. Variation in health care delivery is thus omnipresent and expected, because every patient is unique and medical innovation presents a growing number of care options to choose from….

[The interactive map may be found here]

The top ten Republican states have higher Medicare spending than the top ten Democratic states. The rate of hospitalization and surgical procedures are also higher for Republican states. If we investigate a procedure like percutaneous coronary interventions (PCI), the Republican states are performing more PCI procedures with equal mortality benefit compared to Democratic states. The evidence of variation in cost and utilization is a strong indication of inconsistency and inefficiency in the care delivery process. Are the Republican states providing better care by providing more care? We cannot find evidence of for such an assertion. Nor do we find evidence of harm occurring from a lack of utilization to individuals residing in democratic states. Six of the ten Republican states sued the federal government over the individual mandate and Medicaid expansion earlier this year (Utah, Alabama, Louisiana, Texas, Georgia, and Nebraska), compared to only one democratic majority state (Maine). Yet the Republican states have a higher average of uninsured people, thus inhibiting a greater percentage of their citizens from accessing preventive healthcare….

Read the entire article here

December 28, 2012 Posted by | health care | , , , , | Leave a comment

Public health extremism (Obama Care, Health Law, and Bioethics)

Johns Hopkins University Press Blog

Guest post by Maxwell J. Mehlman

In a November article for the New England Journal of Medicine, Harvard law professors Michelle Mello and Glenn Cohen argue that in upholding the Affordable Care Act’s individual insurance mandate as a tax the Supreme Court “has highlighted an opportunity for passing creative new public health laws.” As a bioethicist who writes extensively on the question of coercive public health this troubled me on several fronts.  In this case, Mello and Cohen give an example of the laws that they have in mind: higher taxes on people whose body-mass index falls outside of the normal range, who do not produce an annual health improvement plan with their physician, who do not purchase gym memberships, who are diabetic but fail to control their glycated hemoglobin levels, and who do not declare that they were tobacco-free during the past year.

Some of these suggestions seem ineffectual…

View original post 411 more words

December 27, 2012 Posted by | Medical and Health Research News | , , , , , , , , , | Leave a comment

Health Insurance Exchanges Will Transform Health Care. Magically Increase Transparency. Improve Access. And Maybe Even Lower Costs. But Only if We Get it Right …

 

From December 8, 2012 posting at The Health Care Blog

…So while I am heartened by how consumer-driven health care has become – retail clinics, quality rankings as examples – I’m reminded that we are only as consumer-centric as our weakest link(s). For every example I have, I know that there are many more. There are plenty of weak links throughout the healthcare system. Like Kohl’s, each of us can look at the top things that make our business difficult for people to deal with. With often only modest effort, we can make changes to significantly improve the consumer experience, lower frustration and minimize confusion……

 

 

December 11, 2012 Posted by | health care | , , , | Leave a comment

   

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